Medicare cuts looming

AMA urges Congress to hold off on doc pay cuts

The American Medical Association called for Congress to stall an upcoming Medicare pay cut to doctors for more than a year, after a CMS rule on the cut was released last week.

The AMA urged Congress to postpone a scheduled cut to Medicare physician pay, which the CMS announced last week would reduce reimbursement to doctors by 24.9% as of Jan. 1 under the sustainable growth-rate formula. Medicare is scheduled to reduce doctor reimbursement by 23% as of Dec. 1 and another 1.9% one month later, absent a move by Congress.

“Congress needs to send a strong message that seniors and physicians can count on Medicare by stopping the cut for at least 13 months, providing time for Congress to fix the Medicare mess once and for all,” said AMA President Cecil Wilson in a written statement.

The CMS noted in its final payment rule that Congress has authority—and has used it each year since 2003—to override the cuts and described a long-term solution as critical. “We are committed to permanently reforming the Medicare payment formula,” the CMS said.

The agency last week also published final rules for home-health agencies, which will see payments reduced by 4.89% in 2011, and outpatient hospital and ambulatory-surgery centers. The home-care payment cuts will amount to $960 million in 2011, the agency said.

The Ambulatory Surgery Center Association said it was pleased that the final rule increases ASC payments by 0.2%, as opposed to a freeze in rates proposed earlier.

Final rules for outpatient hospital and ambulatory-surgery centers included some changes called for under the Patient Protection and Affordable Care Act, including a ban on new or expanded physician-owned hospitals and efforts to redistribute unused medical residency slots among medical schools.

The outpatient hospital and surgery center rule also increases the quality measures that must be reported in 2012, 2013 and 2014 to receive full payment. The agency said it would increase to 15 from 11 the number of measures reported in 2012 and add another eight in 2013 but said no new measures would be adopted in 2014.